Physician Workforce Exploring Obstacles to and Opportunities for Professional Success Among Ethnic Minority Medical Students Kara L. Odom, MD, MPH, Laura Morgan Roberts, PhD, Rachel L. Johnson, MD, PhD, and Lisa A. Cooper, MD, MPH Abstract Purpose To explore the barriers and facilitators experienced by ethnic minority medical students in achieving personal and professional success. Method In 2002 and 2003, 43 minority medical students participated in one of six two-hour focus groups located in Philadelphia, Pa; Kansas City, Mo; Baltimore, Md; Miami, Fl; New York, NY; and Los Angeles, Calif. Focus groups consisted of an average of seven (range 5–10) individuals. Eighty-eight percent were of black/African descent, 10% were Hispanic, and 2% were Asian/Pacific Islanders. Students discussed their views of personal and professional success, including opportunities and obstacles, and completed a brief demographic survey. Discussions were audiotaped, transcribed verbatim, and reviewed for thematic content in a three-stage independent review/adjudication process. Results All 748 comments were grouped into themes relating to definitions of success (35%) and to perceived facilitators (25%) or inhibitors (40%) of success. Participants strove to achieve professional/academic status, financial security, and quality of life. In so doing, participants identified facilitators of success, including support systems, professional exposure, financial aid, and personal characteristics. Lack of financial and social support, challenges with standardized tests, experiences with racial stereotyping and discrimination, and self-imposed barriers were among inhibitors to success. Conclusions The opportunities for and barriers to academic success identified by minority students should be heeded by educators and administrators who develop programs and policies to recruit minority medical students and to ensure their professional development. To enhance the institutional climate for diversity, programs that improve cultural awareness and reduce biases among all students, faculty, staff, and administrators are needed. Acad Med. 2007; 82:146–153. As the population of the United States becomes more ethnically diverse, and as a growing body of research links diversity in the physician workforce to improving health care quality and access for racial and ethnic minorities, medical educators and administrators are challenged to develop effective programs for recruiting and retaining underrepresented minority (URM) medical students. 1–4 Despite many aggressive initiatives by the Association of American Medical Colleges (AAMC) to increase the numbers of URMs attending medical school (i.e., Project 3,000  2000), the success of such programs is hindered by difficulties that URM students enrolled in medical school face on their career paths through graduation and later in residency and faculty positions. 5–7 URM medical students face the unique challenge of working with professors, attending physicians, residents, and colleagues whose cultural backgrounds are very different from their own. Moreover, URM medical students have reported stresses and challenges associated with learning in what they perceive to be a prejudiced and hostile environment. 8–9 Medical educators and administrators need a plan of action and specific programmatic recruitment and retention strategies to encourage minority students to enter health careers for the benefit of all patient populations. The ability of pipeline programs to achieve desired goals (i.e., increasing the number of ethnic minority physicians with successful careers) may be enhanced by developing a better understanding of the barriers faced by minority students upon their matriculation in medical school and by identifying the factors that promote success. Much of the current research on the quality of medical students’ experiences is presented from the perspective of medical school or academic health center administration. 10 –15 It is unclear whether the assumptions made by administrators, researchers, and educators regarding minority students’ opportunities for and obstacles to professional success in medical school are substantiated by students’ experiences. Our study questions were as follows: (1) What factors have facilitated URM medical students’ personal and professional success? (2) What challenges have inhibited their personal and professional success? Dr. Odom is a third-year resident, Department of Family and Community Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. Dr. Morgan Roberts is assistant professor, Harvard Business School, Harvard University, Boston, Massachusetts. Dr. Johnson is a third-year resident, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Dr. Cooper is associate professor, Department of Medicine, Johns Hopkins University School of Medicine and Departments of Epidemiology and Health Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Correspondence should be addressed to Dr. Cooper, Associate Professor of Medicine, Epidemiology, and Health Behavior and Society, Johns Hopkins Medical Institutions, Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 2-500, Baltimore, MD 21287; telephone: (410) 614-3659; fax: (410) 614-0588; e-mail: (lisa.cooper@jhmi.edu). Academic Medicine, Vol. 82, No. 2 / February 2007 146